改良Poppen入路显微切除成人松果体区肿瘤的疗效分析

Therapeutic effect of modified Poppen approach for microsurgical removal of adult pineal region tumors

目的探讨经改良Poppen入路显微切除成人松果体区肿瘤的经验和疗效。方法安徽医科大学附属省立医院神经外科自2013年8月至2018年1月采用改良Poppen入路切除成人松果体区肿瘤25例,回顾分析25例患者的临床资料和随访结果。结果本组患者中肿瘤全切除21例(84%),次全切除3例(12%),部分切除1例(4%)。术后并发枕叶挫伤2例,同向性偏盲4例,眼球运动障碍3例,颅内感染1例,无手术死亡病例。1例患者术后半年行脑室-腹腔分流术,多数患者术后临床症状有不同程度改善。结论采用改良Poppen入路切除松果体区肿瘤可获得充足的视野及操作空间,更好地提高手术安全性,降低并发症发生率。

Objective To investigate the experience and efficacy of microscopic resection of adult pineal region tumors with modified Poppen approach.Methods The clinical data and follow-up results of 25 patients with adult pineal region tumors resected through modified Poppen approach in the Department of Neurosurgery of the Provincial Hospital affiliated to Anhui Medical University from August 2013 to January 2018,were analy retrospectively.Results Of 25 patients,21(84%)received total tumor resection,3(12%)subtotal resection,and 1(4%)partial resection.There were 2 cases of occipital contusion after operation,4 of homonymous hemianopia,3 of ocular dyskinesia,1 of intracranial infection,and no operative death.One patient underwent ventriculo-peritoneal shunt half a year after surgery.Most patients had different degrees of improvement of clinical symptoms after surgery.Conclusion The modified Poppen approach for resection of the pineal region tumor can obtain sufficient visual field and operation space to improve the safety of surgery and reduce the incidence of complications.